Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.

<h4>Background</h4>Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-e...

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Autores principales:	Joost F von Schmidt auf Altenstadt, Chantal W P M Hukkelhoven, Jos van Roosmalen, Kitty W M Bloemenkamp
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6db46d6499fe4b4d889aaf1006bf9fae
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spelling	oai:doaj.org-article:6db46d6499fe4b4d889aaf1006bf9fae2021-11-18T08:41:25ZPre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.1932-620310.1371/journal.pone.0081959https://doaj.org/article/6db46d6499fe4b4d889aaf1006bf9fae2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24367496/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia and postpartum haemorrhage. Our secondary objective was to identify other risk indicators for postpartum haemorrhage in the Netherlands.<h4>Methods</h4>A nationwide cohort was used, containing prospectively collected data of women giving birth after 19 completed weeks of gestation from January 2000 until January 2008 (n = 1,457,576). Data were extracted from the Netherlands Perinatal Registry, covering 96% of all deliveries in the Netherlands. The main outcome measure, postpartum haemorrhage, was defined as blood loss of ≥1000 ml in the 24 hours following delivery. The association between pre-eclampsia and postpartum haemorrhage was investigated with uni- and multivariable logistic regression analyses.<h4>Results</h4>Overall prevalence of postpartum haemorrhage was 4.3% and of pre-eclampsia 2.2%. From the 31 560 women with pre-eclampsia 2 347 (7.4%) developed postpartum haemorrhage, compared to 60 517 (4.2%) from the 1 426 016 women without pre-eclampsia (odds ratio 1.81; 95% CI 1.74 to 1.89). Risk of postpartum haemorrhage in women with pre-eclampsia remained increased after adjusting for confounders (adjusted odds ratio 1.53; 95% CI 1.46 to 1.60).<h4>Conclusion</h4>Women with pre-eclampsia have a 1.53 fold increased risk for postpartum haemorrhage. Clinicians should be aware of this and use this knowledge in the management of pre-eclampsia and the third stage of labour in order to reach the fifth Millenium Developmental Goal of reducing maternal mortality ratios with 75% by 2015.Joost F von Schmidt auf AltenstadtChantal W P M HukkelhovenJos van RoosmalenKitty W M BloemenkampPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e81959 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joost F von Schmidt auf Altenstadt Chantal W P M Hukkelhoven Jos van Roosmalen Kitty W M Bloemenkamp Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
description	<h4>Background</h4>Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia and postpartum haemorrhage. Our secondary objective was to identify other risk indicators for postpartum haemorrhage in the Netherlands.<h4>Methods</h4>A nationwide cohort was used, containing prospectively collected data of women giving birth after 19 completed weeks of gestation from January 2000 until January 2008 (n = 1,457,576). Data were extracted from the Netherlands Perinatal Registry, covering 96% of all deliveries in the Netherlands. The main outcome measure, postpartum haemorrhage, was defined as blood loss of ≥1000 ml in the 24 hours following delivery. The association between pre-eclampsia and postpartum haemorrhage was investigated with uni- and multivariable logistic regression analyses.<h4>Results</h4>Overall prevalence of postpartum haemorrhage was 4.3% and of pre-eclampsia 2.2%. From the 31 560 women with pre-eclampsia 2 347 (7.4%) developed postpartum haemorrhage, compared to 60 517 (4.2%) from the 1 426 016 women without pre-eclampsia (odds ratio 1.81; 95% CI 1.74 to 1.89). Risk of postpartum haemorrhage in women with pre-eclampsia remained increased after adjusting for confounders (adjusted odds ratio 1.53; 95% CI 1.46 to 1.60).<h4>Conclusion</h4>Women with pre-eclampsia have a 1.53 fold increased risk for postpartum haemorrhage. Clinicians should be aware of this and use this knowledge in the management of pre-eclampsia and the third stage of labour in order to reach the fifth Millenium Developmental Goal of reducing maternal mortality ratios with 75% by 2015.
format	article
author	Joost F von Schmidt auf Altenstadt Chantal W P M Hukkelhoven Jos van Roosmalen Kitty W M Bloemenkamp
author_facet	Joost F von Schmidt auf Altenstadt Chantal W P M Hukkelhoven Jos van Roosmalen Kitty W M Bloemenkamp
author_sort	Joost F von Schmidt auf Altenstadt
title	Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
title_short	Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
title_full	Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
title_fullStr	Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
title_full_unstemmed	Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.
title_sort	pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the netherlands.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/6db46d6499fe4b4d889aaf1006bf9fae
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Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.

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